B2B Sigup Form

Agent User Name*
(Max. Length 20)
Password* (Max. Length 20)
Confirm Password*
Company Details 
Company Name *
Contact Person * (Max. Length 20)
Address *
Country *
State *
City *
Zip Code *
Phone * - -
- -
PAN card number
Email *
Notes About Agent
Business Details
Approx.Room Night Expected / Year
Area Specialisation
Vouchered Or Reconfirmed Credit Limit
Blocking Credit Limit
TDS Percentage %
Agent Logo [ Size 150px X 150px ]
Should This agent have facility to Block Rooms in Agent Login Yes    No
Automatically Send email of Login Details To Agent Yes    No
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